Major Data Themes in Clinician Responses to Survey
| Total Number of Respondents | Total Positive Responses, n (%) | |
|---|---|---|
| 1. Many barriers exist to the treatment of CNCP, including many uncertainties in optimal management | ||
| Behavioral health care not financially accessible to CNCP patients* (% yes) | 426 | 199 (47%) |
| Substance abuse counselor not financially accessible to CNCP patients* (% yes) | 421 | 143 (34%) |
| Pain specialist not financially accessible to CNCP patients* (% yes) | 422 | 172 (41%) |
| Complementary/alternative medicine providers (e.g., acupuncture, herbalists) not financially accessible to CNCP patients* (% yes) | 421 | 190 (45%) |
| Need for more CNCP continuing medical education (% agree/strongly agree) | 468 | 204 (44%) |
| Long-acting opioids are over-utilized for many CNCP patients in my community (% agree/strongly agree) | 489 | 212 (43%) |
| Long-acting opioids are under-utilized for many CNCP patients in my community (% agree/strongly agree) | 489 | 152 (31%) |
| 2. For many patients, CNCP is a complex biopsychosocial condition for which a multidisciplinary approach is needed | ||
| Experience discomfort in managing CNCP because of: (% some/moderate/much discomfort) | ||
| Patient behavioral health issues* | 400 | 383 (96%) |
| Lack of a defined mechanism of pain* | 406 | 371 (91%) |
| Lack of full work-up for cause of pain* | 406 | 377 (93%) |
| Observe common reasons for uncontrolled pain in CNCP patients: (% agree/strongly agree) | ||
| Depression, anxiety, other mental health disorders | 469 | 439 (94%) |
| Alcohol or other substance use disorders | 467 | 354 (76%) |
| Poor coping skills for pain | 469 | 402 (86%) |
| Poor coping skills for other life stressors* | 401 | 371 (93%) |
| Use massage therapy (% ever used) | 486 | 379 (78%) |
| Use acupuncture (% ever used) | 486 | 354 (73%) |
| Find cognitive behavioral therapy helpful (% somewhat/very helpful) | 490 | 330 (67%) |
| Find biofeedback, meditation, or relaxation therapy helpful (% somewhat/very helpful) | 491 | 306 (62%) |
| 3. Prescription opioid abuse is a serious problem | ||
| Report patients ever divert opioids (% yes) | 489 | 341 (70%) |
| Report having had patients with severe adverse event due to CNCP opioid use (unintentional life-threatening event or death, or suicide) (% yes) | 489 | 161 (33%) |
| Prescribing opioids limited by (% sometimes/frequently) | ||
| Concern over opioid side effects* | 412 | 329 (80%) |
| Concern over development of dependence* | 415 | 292 (70%) |
| Concern over development of addiction* | 415 | 356 (86%) |
| Concern over malingering/secondary gain* | 416 | 320 (77%) |
| Prescribe long-acting opioids | ||
| No | 484 | 75 (15%) |
| Don't initiate but continue Rx prescribed by others | 484 | 80 (17%) |
| Initiate and continue | 484 | 329 (68%) |
| 4. Significant effort is required to properly assess for efficacy, side effects, and aberrant drug related behavior related to chronic opioid treatment | ||
| Report burden to self in managing CNCP (% fair/large/biggest burden) | 497 | 400 (80%) |
| Report burden to practice in managing CNCP (% fair/large/biggest burden) | 496 | 436 (88%) |
| Report being “troubled” prescribing long-acting opioids for: (% yes) | ||
| Chronic neck/back pain without defined mechanism* | 400 | 236 (59%) |
| Chronic headaches* | 400 | 238 (60%) |
| Chronic pelvic pain* | 400 | 201 (50%) |
| Chronic abdominal pain* | 400 | 221 (55%) |
| Use practice systems for CNCP management: (% yes) | ||
| Use controlled substance agreements | 472 | 407 (86%) |
| Use urine drug screens | 470 | 307 (65%) |
| Use CNCP monitoring tool | 474 | 104 (22%) |
| 5. Perceived benefits of opioids to some patients and commitment to their patients influences clinicians to continue | ||
| View CNCP as important clinical problem (% agree/strongly agree) | 495 | 471 (95%) |
| Concerned about poor quality of life for CNCP patients due to pain* (% agree/strongly agree) | 414 | 401 (97%) |
| Concerned that many CNCP patients receive inadequate pain control* (% agree/strongly agree) | 412 | 266 (65%) |
| Concerned about uncontrolled pain due to lack of access to resources (% agree/strongly agree) | 469 | 343 (73%) |
| Report benefit from patient education (e.g., handouts, web links) (% yes) | 493 | 359 (73%) |
| Report some CNCP patients benefit from opioid treatment* (% yes) | 405 | 316 (78%) |
↵* Question included on long-form version of survey only.
† Number of respondents does not match total sample because of missing data.
CNPC, chronic non-cancer pain.